The Lead Episode 123: A Discussion of Re-Ablation of Atrial Fibrillation Targeting Electrogram Dispersion –The RESTART Trial, Live at HRX 2025
The Lead Podcast presented by Heart Rhythm Society
Release Date: 10/16/2025
The Lead Episode 135: A Discussion of Mechanical Vacuum Aspiration and Debulking of Large Vegetations During Cardiac Implantable Electronic Device Extraction
The Lead Podcast presented by Heart Rhythm Society
Welcome to this week's episode of The Lead. Join HRS Digital Education Committee member and podcast host Danesh Kella, MBBS, FHRS as he welcomes his guests Rahul N Doshi, MD, FHRS and Robert D Schaller, DO, FHRS. They are discussing Mechanical Vacuum Aspiration and Debulking of Large Vegetations During Cardiac Implantable Electronic Device Extractions, which was published in the Journal of the American College of Cardiology in October 2025. This article describes the use of mechanical vacuum aspiration systems to debulk large intracardiac vegetations during cardiac...
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The Lead Episode 134: A Discussion of Bachmann Bundle Pacing Target: Retrograde Mapping and Microstructural Correlation
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Deep Chandh Raja, MBBS, MD, PhD , and his guests Georgios Leventopoulos, MD, and Muthiah Subramanian, MD, CCDS, CEPS-A, for this week's Lead episode. This Heart Rhythm article investigates the Bachmann bundle as a target for pacing by using retrograde electrical mapping and correlating findings with underlying myocardial microstructure. The piece provides detailed insights into how Bachmann bundle activation pathways relate to tissue architecture, with implications for optimizing physiologic pacing strategies. These findings may...
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The Lead Episode 133: A Discussion of Feasibility and Safety of PFA for Coronary Sinus and Left Atrial Appendage Isolation and Mitral Isthmus Ablation Acute and Chronic Findings (LIVE at APHRS 2025)
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Chair and podcast host Michael S. Lloyd, MD, FHRS, and his guests Kelvin C. Chua, MBBS, MD, FHRS, CEPS-A, and Rahul N Doshi, MD, FHRS, for this week's Lead episode, which was recorded live at APHRS 2025 in Kyoto, Japan. This discussion will review recent evidence on the feasibility and safety of pulsed field ablation (PFA) for coronary sinus and left atrial appendage isolation, as well as mitral isthmus ablation, focusing on both acute and chronic outcomes. Panelists will examine procedural considerations, lesion durability, and safety signals highlighted in...
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The Lead Episode 132: A Discussion of Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation (English Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Melissa E. Middeldorp, MPH, PhD, and her guests Helmut Pürerfellner, MD, FHRS, and Jonathan M. Kalman, MBBS, PhD, FHRS for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. The OCEAN randomized trial found that in patients who remained free of atrial arrhythmia at least one year after successful catheter ablation for atrial fibrillation, continuing anticoagulation with rivaroxaban did not significantly reduce the risk of stroke, systemic embolism, or covert cerebral infarcts compared with...
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A Discussion of Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation (Japanese Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Join podcast host Takanori Yamaguchi, MD, PhD, and his guests Masato Fukunaga, MD, PhD and Masateru Takigawa, MD, PhD, for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. This episode was recorded entirely in Japanese. The OCEAN randomized trial found that in patients who remained free of atrial arrhythmia at least one year after successful catheter ablation for atrial fibrillation, continuing anticoagulation with rivaroxaban did not significantly reduce the risk of stroke, systemic embolism, or covert cerebral infarcts compared with...
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The Lead Episode 131: A Discussion of Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial (English Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Melissa E. Middeldorp, MPH, PhD, and her guests Eue-Keun Choi, MD, PhD, and Sandeep Prabhu, MBBS, PhD for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. The DECAF trial investigated whether continuing regular caffeinated coffee consumption versus complete abstinence affected the recurrence of atrial fibrillation (AF) or atrial flutter in patients after successful cardioversion. Over six months in this randomized study of 200 adults, those who drank at least one cup of caffeinated coffee...
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The Lead Episode 131: A Discussion of Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial (Japanese Episode)
The Lead Podcast presented by Heart Rhythm Society
Join podcast host Takanori Yamaguchi, MD, PhD, and his guests Koichi Magashina, MD, PhD, and Michifumi Tokuda, MD, PhD for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. This episode is recorded entirely in Japanese. The DECAF trial investigated whether continuing regular caffeinated coffee consumption versus complete abstinence affected the recurrence of atrial fibrillation (AF) or atrial flutter in patients after successful cardioversion. Over six months in this randomized study of 200 adults, those who drank at least one cup of caffeinated...
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A Holiday Message from the Producers of The Lead
The Lead Podcast presented by Heart Rhythm Society
Hello everyone! We're writing to wish you a very happy holiday season. The Lead will be going dark for the next two weeks, as we celebrate with friends and family. As the year comes to a close, we want to thank all of you for being a part of The Lead podcast. We couldn't do it without you! We will be back with more cutting edge content and important discussions the week of January 5, 2026. In the meantime, we wish you a joyful end to 2025 and great beginnings in 2026!
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The Lead Episode 130: A Discussion of MEPPC Syndrome: A Systematic Review and State-of-the-Art Paper
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Deep Chandh Raja, MBBS, MD, PhD (Kauvery Hospital), and his guests Nitish Badhwar, MBBS, FHRS (Stanford University), and Yash Lokhandwala, MD, DM, FACC (Holy Family Hospital) for this week's Lead episode. This state-of-the-art review synthesizes current knowledge on multifocal ectopic Purkinje-related premature contractions (MEPPC) syndrome, highlighting its genetic underpinnings, distinctive electrophysiologic features, and clinical presentation across age groups. The authors emphasize advances in diagnosis and management,...
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The Lead Episode 129: A Discussion of Worldwide Chronic Retrieval Experience of the Helix Fixation Leadless Cardiac Pacemaker
The Lead Podcast presented by Heart Rhythm Society
Join Tina Baykaner, MD, MPH, HRS Digital Education Committee Vice-Chair, and her guests Mikhael F. El-Chami, MD, FHRS and Devi G. Nair, MD, FHRS for this week's Lead episode. This article summarizes the worldwide experience retrieving chronically implanted active helix-fixation leadless ventricular pacemakers (the Aveir/Abbott platform) across regulatory clinical trials. The authors assess real-world feasibility, procedural techniques, success rates, and complications of retrieval after long dwell times, demonstrating that devices can be removed safely and effectively even years after...
info_outlineJoin host and HRS Digital Education Committee Vice-Chair, Tina Baykaner, MD, MPH and her guests Jerome Kalifa, MD and Paul C. Zei, MD, PhD, FHRS as they discuss this article at HRX 2025 in Atlanta.
The RESTART trial is an international, multicenter, non-randomized interventional study designed to assess whether using Volta Medical’s AI-assisted algorithm to identify and ablate dispersed electrograms (EGMs) in addition to doing repeat pulmonary vein isolation can improve outcomes in patients whose atrial fibrillation recurred after previous ablations.The main goal is to see the proportion of patients who are free from AF twelve months after the repeat procedure (without antiarrhythmic drugs), and the trial contains about 92 patients.
Learning Objective
Describe the design and purpose of the RESTART trial, including how the use of AI-guided identification and ablation of dispersed electrograms aims to improve outcomes for patients undergoing repeat ablation for recurrent atrial fibrillation.
Article Authors
- John D. Hummel
- Haroon Rachid
- Isabel Deisenhofer
- Paul C. Zei
- Gustavo Morales
- Jerome Horvilleur
- Stavros Mountantonakis
- Jean-Paul Albenque
- Devi G. Nair
- Benjamin D’Souza
- Smit C. Vasaiwala
- Tom De Potter
- Daniel H. Cooper
- Mark Metzl
- Adi Lador
- Anthony R. Magnano
- Alexandru B. Chicos
- Joshua R. Silverstein
- Daniel Guerrero
- Shirley Beguin
- Anas El-Benna
- Sabine Lotteau
- Marie-Sophie Nguyen-Tu
- Paola Milpied
- Jerome Kalifa
- Bradley P. Knight
- Dhanunjaya R. Lakkireddy
Podcast Contributors
Jerome Kalifa, MD
Paul C. Zei, MD, PhD, FHRS
Tina Baykaner, MD, MPH
All relevant financial relationships have been mitigated.
Host Disclosure(s):
T. Baykaner
•Honoraria/Speaking/Consulting: Volta Medical, Medtronic, Pacemate, Johnson and Johnson, Abbot Medical, Boston Scientific
Contributor Disclosure(s):
J. Kalifa:
P. Zei
•Research: Biosense Webster, Inc.
Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
S. Sailor: No relevant financial relationships with ineligible companies to disclose.